Chronic fatigue syndrome (CFS): Who’s at risk? http://www.cdc.gov/cfs/causes/risk-groups.html. Accessed Feb 9, 2013.
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994;121:953-959.
Carruthers BM, Jain AK, De Meirleir KL, et al. Myalgic encephalomyelitis/chronic fatigue syndrome. J Chronic Fatigue Syndr. 2003;11:7-115.
Jason LA, Evans M, Porter N, et al. The development of a revised Canadian myalgic encephalomyelitis chronic fatigue syndrome case definition. Am J Biochem Biotechnol. 2010;6:120-135.
Sharpe M, Archard LC, Banatvala JE, et al. A report--chronic fatigue syndrome: guidelines for research. J R Soc Med. 1991;84:118-121.
Holmes GP, Kaplan JE, Gantz NM, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988;108:387-389.
Stewart JM, Gewitz MH, Weldon A, Arlievsky N, Li K, Munoz J. Orthostatic intolerance in adolescent chronic fatigue syndrome. Pediatrics. 1999;103:116-121.
Stewart JM, Gewitz MH, Weldon A, Munoz J. Patterns of orthostatic intolerance: the orthostatic tachycardia syndrome and adolescent chronic fatigue. J Pediatr. 1999;135:218-225.
Barron DF, Cohen BA, Geraghty MT, Violand R, Rowe PC. Joint hypermobility is more common in children with chronic fatigue syndrome than in healthy controls. J Pediatr. 2002;141:421-425.
Chronic fatigue syndrome: causes. http://www.cdc.gov/cfs/hcp.html. Accessed Feb 10, 2013.
Fossey M, Libman E, Bailes S, et al. Sleep quality and psychological adjustment in chronic fatigue syndrome. J Behav Med. 2004;27:581-605.
Jason LA, Benton M, Torres-Harding S, Muldowney K. The impact of energy modulation on physical functioning and fatigue severity among patients with ME/CFS. Patient Educ Couns. 2009;77:237-241.
Choy E, Marshall D, Gabriel ZL, Mitchell SA, Gylee E, Dakin HA. A systematic review and mixed treatment comparison of the efficacy of pharmacological treatments for fibromyalgia. Semin Arthritis Rheum. 2011;41:335-345.
Lange G, Janal MN, Maniker A, et al. Safety and efficacy of vagus nerve stimulation in fibromyalgia: a phase I/II proof of concept trial. Pain Med. 2011;12:1406-1413.
Pain and Fatigue Study Center. www.painandfatigue.com. Accessed February 14, 2013.
Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21:69-72.
Bou-Holaigah I, Rowe PC, Kan J, Calkins H. Relationship between neurally mediated hypotension and the chronic fatigue syndrome. JAMA. 1995;274:961-967.
Hickie I, et al. The psychiatric status of patients with the chronic fatigue syndrome. Br J Psychiatry. 1990;156:534-540.
Freeman R. Treatment of orthostatic hypotension. Semin Neurol. 2003;23(4):435-42.
Fortunato JE, Shaltout HA, Larkin MM, et al. Fludrocortisone improves nausea in children with orthostatic intolerance (OI). Clin Auton Res. 2011;21(6):419-23.
Cochran JW, Effect of Modafinil on Fatigue Associated with Neurological Illnesses. J Chronic Fatigue syndrome. 2001; 8:65-70.
Randall DC, Cafferty FH, Shneerson JM, et al. Chronic treatment with modafinil may not be beneficial in patients with chronic fatigue syndrome. J Psychopharmacol. 2005;19(6):647-60.
Blockmans D, Persoons P, Van Houdenhove B, et al. Does methylphenidate reduce the symptoms of chronic fatigue syndrome? Am J Med. 2006;119(2):167.e23-30.
Olson LG, Ambrogetti A, Sutherland DC. A pilot randomized controlled trial of dexamphetamine in patients with chronic fatigue syndrome. Psychosomatics. 2003 Jan-Feb;44(1):38-43.

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Author(s)

Lisa W. Corbin, MD

Associate Professor, Department of Internal Medicine, University of Colorado; Medical Director, Center for Integrative Medicine, University of Colorado Hospital, Aurora, Colorado

Disclosures

Disclosure: Lisa W. Corbin, MD, has disclosed no relevant financial relationships.

Dr Corbin does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Corbin does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Anthony L. Komaroff, MD

Professor of Medicine, Harvard Medical School; Senior Physician, Brigham & Women's Hospital, Boston, Massachusetts

Disclosures

Disclosure: Anthony L. Komaroff, MD, has disclosed no relevant financial relationships.

Dr Komaroff does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Komaroff does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Benjamin H. Natelson, MD

Professor of Neurology, Albert Einstein College of Medicine, Bronx, New York; Director, Pain & Fatigue Study Center, Department of Pain Medicine, Beth Israel Medical Center, New York, New York

Disclosures

Disclosure: Benjamin H. Natelson, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: electroCore Medical, LLC

Dr Natelson does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Natelson does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Peter C. Rowe, MD

Sunshine Natural Wellbeing Foundation Professor; Director, Children’s Center Chronic Fatigue Clinic, Johns Hopkins Medicine, Baltimore, Maryland

Participation by Dr Rowe in the development of this product does not constitute or imply endorsement by the Johns Hopkins University or the Johns Hopkins Hospital and Health System.

Disclosures

Disclosure: Peter C. Rowe, MD, has disclosed no relevant relevant financial relationships.

Dr Rowe does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Rowe does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor(s)

Emilie McCardell

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Emilie McCardell has disclosed no relevant financial relationships.

CME Reviewer(s)

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

CME

A Case-Based Approach to Chronic Fatigue Syndrome

Authors: Lisa W. Corbin, MD; Anthony L. Komaroff, MD; Benjamin H. Natelson, MD; Peter C. Rowe, MD
CME Released: 4/19/2013
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 4/19/2014, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for primary care providers, obstetrician/gynecologists, and pediatricians.

The goal of this activity is to improve diagnosis and management of chronic fatigue syndrome (CFS).

Upon completion of this activity, participants will be able to:

Introduce the 1994 International Case Definition to diagnose patients with CFS
Outline the CFS symptom spectrum across different populations, including adults and adolescents
Formulate a treatment plan that targets symptoms and manages medications
Demonstrate ability to manage CFS on an individual basis through patient-case examples

Disclosures

Author(s)

Lisa W. Corbin, MD

Associate Professor, Department of Internal Medicine, University of Colorado; Medical Director, Center for Integrative Medicine, University of Colorado Hospital, Aurora, Colorado

Disclosures

Disclosure: Lisa W. Corbin, MD, has disclosed no relevant financial relationships.

Dr Corbin does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Corbin does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Anthony L. Komaroff, MD

Professor of Medicine, Harvard Medical School; Senior Physician, Brigham & Women's Hospital, Boston, Massachusetts

Disclosures

Disclosure: Anthony L. Komaroff, MD, has disclosed no relevant financial relationships.

Dr Komaroff does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Komaroff does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Benjamin H. Natelson, MD

Professor of Neurology, Albert Einstein College of Medicine, Bronx, New York; Director, Pain & Fatigue Study Center, Department of Pain Medicine, Beth Israel Medical Center, New York, New York

Disclosures

Disclosure: Benjamin H. Natelson, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: electroCore Medical, LLC

Dr Natelson does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Natelson does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Peter C. Rowe, MD

Sunshine Natural Wellbeing Foundation Professor; Director, Children’s Center Chronic Fatigue Clinic, Johns Hopkins Medicine, Baltimore, Maryland

Participation by Dr Rowe in the development of this product does not constitute or imply endorsement by the Johns Hopkins University or the Johns Hopkins Hospital and Health System.

Disclosures

Disclosure: Peter C. Rowe, MD, has disclosed no relevant relevant financial relationships.

Dr Rowe does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Rowe does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor(s)

Emilie McCardell

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Emilie McCardell has disclosed no relevant financial relationships.

CME Reviewer(s)

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

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From Medscape Education Family Medicine

CME

A Case-Based Approach to Chronic Fatigue Syndrome

Authors: Lisa W. Corbin, MD; Anthony L. Komaroff, MD; Benjamin H. Natelson, MD; Peter C. Rowe, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME Released: 4/19/2013

Valid for credit through: 4/19/2014, 11:59 PM EST

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The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Author(s)

Lisa W. Corbin, MD

Anthony L. Komaroff, MD

Benjamin H. Natelson, MD

Peter C. Rowe, MD

Editor(s)

Emilie McCardell

CME Reviewer(s)

Nafeez Zawahir, MD

CME

A Case-Based Approach to Chronic Fatigue Syndrome

Target Audience and Goal Statement

Disclosures

Author(s)

Lisa W. Corbin, MD

Anthony L. Komaroff, MD

Benjamin H. Natelson, MD

Peter C. Rowe, MD

Editor(s)

Emilie McCardell

CME Reviewer(s)

Nafeez Zawahir, MD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

A Case-Based Approach to Chronic Fatigue Syndrome